Abstract
PurposeThe purpose of this study is to investigate anatomic and morphologic features of inner and outer retinal layers in patients recovered from COVID-19 with Spectral Domain Optical Coherence Tomography (SD-OCT), whether correlate with any symptoms during disease process.Methods32 patients recovered from COVID-19 and age- and gender-matched 36 healthy controls were included in this cross-sectional study. Ganglion cell-inner plexiform layer, macular and peripapiller retinal nerve fiber layer (RNFL), inner nuclear layer (INL), outer nuclear layer (ONL), outer plexiform layer (OPL) and the outer retinal hyperreflective bands including external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IZ) were examined with SD-OCT. The differences of each retinal layers thickness among subgroup analysis of ocular pain and headache were also compared.ResultsMacular RNFL of inner and outer nasal and outer inferior quadrants were thinner in COVID-19 patients compared to healthy control group (p = 0.046, p = 0.014 and p = 0.016, respectively). Thinning in outer superior quadrant of GCIPL and INL quadrants were detected in patients with headache (p = 0.026 and p = 0.01). Superonasal and inferotemporal sectors of pRNFL were thinner in patients with ocular pain compared to patients without ocular pain (p = 0.024 and p = 0.015). Integrity of EZ, ELM and IZ was evaluated as continuous line and protected on each OCT scans.ConclusionThe study demonstrated convincing evidence that SARS-CoV-2 can affect the inner and outer retinal layers, with subclinical localized alterations, particularly in patients with headache and ocular pain symptoms during COVID-19 period.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10792-021-01952-5.
Highlights
Novel coronavirus disease (COVID-19) caused by respiratory syndrome coronavirus 2 (SARS-CoV-2) agent, first reported in Wuhan, China, in December 2019 [1,2,3], along with the fast spread [4] to whole world was declared as pandemic by the World HealthOrganisation [5, 6]
Macular retinal nerve fiber layer (RNFL) of inner and outer nasal and outer inferior quadrants were thinner in COVID-19 patients compared to healthy control group (p = 0.046, p = 0.014 and p = 0.016, respectively)
Thinning in outer superior quadrant of ganglion cell–inner plexiform layer (GCIPL) and inner nuclear layer (INL) quadrants were detected in patients with headache (p = 0.026 and p = 0.01)
Summary
Novel coronavirus disease (COVID-19) caused by respiratory syndrome coronavirus 2 (SARS-CoV-2) agent, first reported in Wuhan, China, in December 2019 [1,2,3], along with the fast spread [4] to whole world was declared as pandemic by the World Health. Organisation [5, 6] Altough it is defined as a respiratory virus, since the angiotensin-converting enzyme II (ACE-2), which the agent attaches [3], is expressed widely in the human body, the disease has the potential to damage many tissues and organs. At the beginning of the pandemic, the publications were mainly about the anterior segment involvement [7,8,9] of the disease and the discussion was whether the transmission is possible from ocular surface [10] and how the best protection should be [11]. Recent studies are evolved to represent retinal involvement of SARS-CoV-2 infection in the ongoing process
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